Tom Noonan Esq

Headfort School

Application Form

Pupil (Please indicate with a )BoyGirl

Day PupilBoarder

Surname:
Forenames:
Date of Birth: Day Month Year
Nationality: Date of Proposed Entry:
Previous School:
Religious Denomination:
Please give the history of any significant illness:
Is he/she allergic to penicillin or any other antibiotic or drug?
Does he/she suffer from any constitutional peculiarity or physical complaint?
Are there any other circumstances that the school should know about?

Parents/Guardian (Please indicate with a  to whom fee claims should be made)

Father Mother

Name: / Name:
Occupation: / Occupation:
Address: / Address:
Tel No. Home: / Tel No. Home:
Mobile No.: / Mobile No.:
Tel No. Business: / Tel No. Business:
Fax No.: / Fax No.:
Email: / Email:

Please turn over/

Side 2 of 2

The Small Print

Payment of Fees: School fees are payable in advance, eight days before the beginning of each term.

The school banks with Bank of Ireland, John Street, Kells, Co. Meath, Ireland.

The account number is 35138886, Sort Code 903445.

The Swift (BIC) Number is BOFI IE 2D

IBAN: IE48 BOFI 9034 4535 1388 86.

It is agreed between the parties that the contract herein was made within the Jurisdiction of the County of Meath, Republic of Ireland.

It is further agreed that one full term's notice in writing, or payment of a term's fee in lieu of such notice, is required prior to the removal of the student from Headfort School.

I, the undersigned, seek admission to Headfort for my ______(state relationship), and enclose the registration fee of €100. This fee is not refundable unless the school refuses admission.

Signature of both parents (where applicable):
Father: / Mother:
Date:

Headfort, Kells, Co. Meath, Ireland. Headmaster: Dermot Dix. Telephone 00353-46-9240065 or 00353-46-9241864

Fax: 00353-46-9241842 Email: Registered Charity Number: CHY 6388